[Provider] Billing MaineCare for Services After Medicare on UB Claim Forms

[Provider Notification]

ATTENTION:  All MaineCare Providers That Bill on UB-92 or UB-04

 

A work-around has been identified to address claims not processing
correctly when billing for Medicare non-covered services on UB92 or UB04
claim forms.

 

When billing for services after Medicare, MeCMS is programmed to look
for a value code.  However, there is no valid value code for Medicare
non-covered services.  When using the word Medicare in field locator 50a
for non-covered charges the system has been inappropriately applying
reimbursable charges to the contractual adjustment.  

 

In order to ensure proper processing of these claims the following
work-around has been identified.  

 

*      UB-92 & UB-04 Field locator 50a should only contain the word
MaineCare. Do not use the word Medicare when billing these non-covered
services.

 

*      UB-92 field locator 51a should contain your billing provider
number assigned by MaineCare.  

 

*      UB-04 field locator 57 should contain your billing provider
number assigned by MaineCare.  Field locator 51a should be left blank.  

 

*      You must submit a paper claim as we require your explanation of
Medicare benefits to process.

 

MaineCare UB Billing Instructions are being updated to reflect this
change.  If you have further questions please contact 1-800-321-5557,
option 8.

 

 

This is a one-way communication.  Please do not respond to this message.

 

 

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